Efavirenz: What It Is, How It Works, and What You Need to Know

When you’re managing HIV, Efavirenz, a non-nucleoside reverse transcriptase inhibitor used to block HIV replication. Also known as Sustiva, it’s one of the most commonly prescribed antiretroviral drugs worldwide, especially in first-line HIV treatment regimens. It doesn’t cure HIV, but when taken daily with other medications, it keeps the virus under control so your immune system can stay strong. Many people start on Efavirenz because it’s effective, affordable, and often part of a single-pill combo — making it easier to stick to a daily routine.

But Efavirenz isn’t without its challenges. About 1 in 3 people experience side effects like dizziness, vivid dreams, or trouble sleeping — especially in the first few weeks. Some report mood changes, including anxiety or depression, which is why doctors monitor mental health closely when prescribing it. It’s also not safe during early pregnancy, and it interacts with a bunch of other drugs — from statins to antifungals — so you need to tell your provider everything you’re taking. If side effects don’t improve after a month, or if they’re too disruptive, switching to another antiretroviral like rilpivirine or doravirine might be the right move. These alternatives work similarly but often have fewer neurological side effects.

What you’ll find below is a collection of real-world comparisons and practical guides that help you understand how Efavirenz fits into the bigger picture of HIV care. You’ll see how it stacks up against other HIV meds, what to do when side effects hit, how drug resistance develops, and how to manage long-term use without losing quality of life. These aren’t just clinical summaries — they’re written by people who’ve been there, and by clinicians who know what actually matters day to day. Whether you’re just starting treatment or have been on Efavirenz for years, the posts here give you the clear, no-fluff facts you need to make smarter choices.